2025-11-10T16:43:26-06:00 2024-12-31 346565596 ERNST & YOUNG US LLP 2005 MARKET ST STE 700 PHILADELPHIA PA 19103 990 2024-01-01 200160881 INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC INTE 8014422000 6355 SOUTH BUFFALO DRIVE LAS VEGAS NV 89113 DEV RAMSAMY REGION VP FINANCE 8014422000 2025-11-10 0 0 LAUREN E BENNETT P01787029 2154485000 2024 2025-03-06 01:10:19Z MITCHELL CLOWARD 6355 SOUTH BUFFALO DRIVE LAS VEGAS NV 89113 1307874993 0 X WWW.INTERMOUNTAINHEALTHCARE.ORG X 2003 DE HELPING PEOPLE LIVE THE HEALTHIEST LIVES POSSIBLE. 10 9 2548 7 0 0 100000 0 1243123780 1298311443 -3910973 3668309 -647687 4692554 1238665120 1306672306 229370 150895 0 0 275624413 287729023 0 0 0 943833892 1051513422 1219687675 1339393340 18977445 -32721034 607201630 593020339 248429595 266969338 358772035 326051001 HELPING PEOPLE LIVE THE HEALTHIEST LIVES POSSIBLE. 0 0 1245284869 150895 1303573926 INTERMOUNTAIN MEDICAL HOLDINGS NEVADA, INC. IS A MEDICAL GROUP THAT OPERATES 99 PRACTICE MEDICAL OFFICES IN 6 CITIES IN NEVADA. THERE ARE 245 HEALTH PROVIDERS SPECIALIZING IN INTERNAL MEDICINE, FAMILY PRACTICE, CARDIOVASCULAR DISEASE (CARDIOLOGY), GENERAL PRACTICE, HEMATOLOGY/ONCOLOGY, CARDIAC ELECTROPHYSIOLOGY, INTERVENTIONAL CARDIOLOGY, INTERNAL MEDICINE AND MORE. THE MAJORITY OF SERVICES PROVIDED BY THE ORGANIZATION ARE THROUGH CAPITATION ARRANGEMENTS. 0 0 0 1245284869 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 2534 0 1 2548 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X PAIGE TRESTON 8014423491 6355 SOUTH BUFFALO DRIVE LAS VEGAS NV 89113 ELIZABETH P BECKMAN TRUSTEE 2.00 2.00 X 0 2294 0 S NEAL BERUBE CHAIR/TRUSTEE 2.00 4.00 X X 0 1131 0 CHIP CHILDS TRUSTEE / VICE-CHAIR 2.00 2.00 X X 0 0 0 MITCHELL CLOWARD TRUSTEE/SEC/REGION PRES 2.00 50.00 X X 0 1178767 265007 CYNDI WOODBURY GILBERT TRUSTEE 2.00 1.00 X 0 0 0 DERRICK HASLEM MD TRUSTEE 2.00 0.00 X 0 0 0 NICOLE MOUSKONDIS TRUSTEE 2.00 1.00 X 0 0 0 DAN SHAW TRUSTEE 2.00 0.00 X 0 0 0 EVAN VICKERS TRUSTEE 2.00 0.00 X 0 0 0 KEITH WHITEFIELD TRUSTEE 2.00 0.00 X 0 0 0 NATALIE ASHBY MARKET PRESIDENT 2.00 51.00 X 0 588875 237340 CLAY L ASHDOWN TREASURER 2.00 59.00 X 0 1890547 1278871 JUSTIN BOLLENBACK REGION VP FINANCE (PARTIAL) 2.00 50.00 X 0 500476 20115 CARA CAMIOLO MD REGION CHIEF MEDICAL OFFICER 2.00 50.00 X 0 836281 203561 RYAN CHRISTENSEN REGION VP OPERATIONS 50.00 0.00 X 609539 0 152563 MIKE CHRISTOPHERSON ASSISTANT SECRETARY 2.00 50.00 X 0 388800 160824 AMY CHURCH VICE PRESIDENT 2.00 56.00 X 0 752763 287460 KEYONA COLE REGION CHIEF NURSING OFFICER 50.00 0.00 X 432603 0 141036 BEAU HARRISON VP STRATEGY 2.00 50.00 X 0 347981 132472 STACY JENNINGS VICE PRESIDENT / CIO 2.00 55.00 X 0 835217 297105 NADIA KHAN REGION VP MARKETING (PARTIAL) 50.00 0.00 X 467073 0 21598 GREG J MATIS SECRETARY 2.00 58.00 X 0 1727776 979605 MELINDA MENDOZA VP/CHIEF COMPLIANCE OFFICER 2.00 55.00 X 0 412668 130848 TRACY STANFORD REGION VP HUMAN RESOURCES 2.00 50.00 X 0 435245 129863 TERRI DRAPER REGION VP MARKETING (PARTIAL) 2.00 50.00 X 0 322300 171792 DEV RAMSAMY REGION VP FINANCE (PARTIAL) 2.00 50.00 X 299465 64173 105670 PRASHANT BHARUCHA MD MEDICAL DIRECTOR 50.00 0.00 X 853127 0 83181 HOWARD BRODER MD MEDICAL DIRECTOR 50.00 0.00 X 941400 0 173736 WILLIAM CHU MD CARDIO INTERVENTION 50.00 0.00 X 826234 0 152461 CUONG NGYUN MD CARDIO/NONINVASIVE 50.00 0.00 X 816505 0 50256 NEVILLE MISTRY MD CARDIO INTERVENTION 50.00 0.00 X 845386 0 39813 SUZANNE DRAPER FORMER OFFICER 0.00 0.00 X 0 1140791 16541 TREVOR SMITH FORMER OFFICER 50.00 0.00 X 375092 0 123121 ROBERT W ALLEN FORMER OFFICER 0.00 64.00 X 0 5410130 4305226 6466424 16836215 9660065 657 1 1 0 ST ROSE DOMINICAN HOSPITAL 3001 ST ROSE PARKWAY HENDERSON NV 89052 MEDICAL 45348626 SUNRISE HOSPITAL AND MEDICAL CENTER 3186 S MARYLAND PARKWAY LAS VEGAS NV 89109 MEDICAL 40651542 SPRING VALLEY HOSPITAL MEDICAL CENTER 5400 S RAINBOW BLVD LAS VEGAS NV 89118 MEDICAL 39345507 SUNRISE MOUNTAINVIEW HOSPITAL 3100 N TENAYA WAY LAS VEGAS NV 89128 MEDICAL 37479332 UNIVERSITY MEDICAL CENTER OF SO NV 1800 W CHARLESTON BLVD LAS VEGAS NV 89102 MEDICAL 28076879 369 CAPITATION REVENUE 621111 1298311443 1298311443 1298311443 3668309 3668309 632758 1202687 -569929 -569929 -569929 ALLOC INTER-BUS REV 5262483 5262483 5262483 1306672306 1303573926 0 3098380 150895 150895 2626625 1996235 630390 235055774 178642388 56413386 8711783 6620955 2090828 22165013 16845410 5319603 19169828 14569069 4600759 33778157 25671399 8106758 16513 12550 3963 8351521 6347156 2004365 3001204 2280915 720289 6698645 5090970 1607675 25390421 19296720 6093701 1481734 1126118 355616 277430 210847 66583 753872 572943 180929 16319997 12403198 3916799 MEDICAL EXPENSES 886077750 886077750 0 MEDICAL SUPPLIES 59327509 59327509 0 RISK MANAGEMENT 7160978 5442343 1718635 ADJ FOR UNPAID SERVICES 1718558 1718558 0 1159133 880941 278192 1339393340 1245284869 94108471 0 3661 4287 67086458 56315296 5523591 6861222 1017947 991991 2344031 2179273 62158888 14880823 37884061 47278065 4189658 4507161 408937855 402154170 80214368 72728874 607201630 593020339 12310462 3559377 1010899 1294610 235108234 262115351 248429595 266969338 X 358772035 326051001 358772035 326051001 607201630 593020339 -32721034 0 X 0 1 X 1 0 X 13903104 13903104 7337810 819933 6517877 12930905 6870637 6060268 12653088 7190253 5462835 15333981 15333981 47278065 RIGHT OF USE ASSET 58196704 OTHER RECEIVABLE 14532170 72728874 ACCRUED PAYROLL 29117364 INTERCOMPANY PAYABLE 76850152 UNCLAIMED PROPERTY 3092574 CAPITAL LEASE OBLIGATION 64223501 MEDICAL CLAIMS 85281760 MALPRACTICE CLAIMS 3550000 262115351 1 TEACH FOR AMERICA INC 701 BRIDGER AVE LAS VEGAS NV 89101 133541913 501(C)(3) 45000 0 SUPPORT COMMUNITY HEALTH SHRINERS HOSPITAL FOR CHILDREN 1680 VILLAGE CENTER CIRCLE LAS VEGAS NV 89134 362193608 501(C)(3) 20000 0 SUPPORT CHILDREN'S HEALTH TOURO UNIVERSITY NEVADA 874 AMERICAN PACIFIC DR HENDERSON NV 89014 200363127 501(C)(3) 15000 0 HEALTH EDUCATION GRANT A GIFT AUTISM FOUNDATION 630 S RANCHO DR STE D LAS VEGAS NV 89106 800350583 501(C)(3) 15000 0 SUPPORT COMMUNITY HEALTH BREAKTHROUGH T1D - DESERT WEST CHAPTER PO BOX 5033 HAGERSTOWN MD 21741 231907729 501(C)(3) 10000 0 SUPPORT COMMUNITY HEALTH NEVADA STRATEGIC GROWTH FUND PO BOX 751271 LAS VEGAS NV 89136 994123174 501(C)(3) 10000 0 SUPPORT COMMUNITY HEALTH UNLV FOUNDATION BOX 451006 4505 S MARYLAND PKWY LAS VEGAS NV 89154 942790134 501(C)(3) 7500 0 HEALTH EDUCATION THE CHILDREN'S HEART FOUNDATION 3131 LA CANADA SUITE 230 LAS VEGAS NV 89196 364077528 501(C)(3) 6200 0 SUPPORT CHILDREN'S HEALTH 8 0 FORM 990, SCHEDULE I, PART I, LINE 2: BY POLICY, INTERMOUNTAIN MEDICAL HOLDINGS NEVADA, INC.'S GRANTS ARE GENERALLY LIMITED TO PUBLIC CHARITIES EXEMPT FROM INCOME TAX UNDER IRC SECTION 501(C)(3) THAT (1) SUPPORT EFFORTS TO IMPROVE HEALTH AND/OR HEALTHCARE AND HUMAN SERVICES OR (2) STRENGTHEN THE LOCAL COMMUNITY. THE ORGANIZATION MONITORS ITS GRANTS TO ENSURE THAT THEY ARE USED FOR PROPER PURPOSES AND NOT OTHERWISE DIVERTED FROM THEIR INTENDED USE BY REQUIRING ORGANIZATIONS THAT RECEIVE FUNDS GREATER THAN $5,000 TO SIGN A LETTER OF INTENT COMMITTING TO THE SPECIFIC USE OF THE FUNDS AND REGULARLY SUBMITTING OUTCOME REPORTS RELATED TO THE USE OF FUNDS. X 1 1 1 1 0 0 0 0 0 0 0 ROBERT W ALLEN FORMER OFFICER 0 2122584 0 3269760 0 17786 0 4182850 0 122376 0 9715356 0 1558166 CLAY L ASHDOWN TREASURER 0 1069349 0 817518 0 3680 0 1211742 0 67129 0 3169418 0 321841 GREG J MATIS SECRETARY 0 842984 0 875227 0 9565 0 918705 0 60900 0 2707381 0 558987 MITCHELL CLOWARD TRUSTEE/SEC/REGION PRES 0 851584 0 244505 0 82678 0 208790 0 56217 0 1443774 0 195232 SUZANNE DRAPER FORMER OFFICER 0 0 0 0 0 1140791 0 0 0 16541 0 1157332 0 0 STACY JENNINGS VICE PRESIDENT / CIO 0 663493 0 171604 0 120 0 252330 0 44775 0 1132322 0 171604 HOWARD BRODER MD MEDICAL DIRECTOR 823701 0 54560 0 63139 0 123978 0 49758 0 1115136 0 0 0 AMY CHURCH VICE PRESIDENT 0 562032 0 157184 0 33547 0 256067 0 31393 0 1040223 0 188440 CARA CAMIOLO MD REGION CHIEF MEDICAL OFFICER 0 599513 0 235369 0 1399 0 180765 0 22796 0 1039842 0 171063 WILLIAM CHU MD CARDIO INTERVENTION 731936 0 2344 0 91954 0 111325 0 41136 0 978695 0 0 0 PRASHANT BHARUCHA MD MEDICAL DIRECTOR 810401 0 41397 0 1329 0 61140 0 22041 0 936308 0 0 0 NEVILLE MISTRY MD CARDIO INTERVENTION 762697 0 1904 0 80785 0 15216 0 24597 0 885199 0 0 0 CUONG NGYUN MD CARDIO/NONINVASIVE 737287 0 2264 0 76954 0 20700 0 29556 0 866761 0 0 0 NATALIE ASHBY MARKET PRESIDENT 0 502348 0 84995 0 1532 0 190665 0 46675 0 826215 0 84995 RYAN CHRISTENSEN REGION VP OPERATIONS 493013 0 115029 0 1497 0 134597 0 17966 0 762102 0 115029 0 KEYONA COLE REGION CHIEF NURSING OFFICER 345588 0 85518 0 1497 0 100921 0 40115 0 573639 0 61990 0 TRACY STANFORD REGION VP HUMAN RESOURCES 0 346202 0 87686 0 1357 0 99217 0 30646 0 565108 0 87686 MIKE CHRISTOPHERSON ASSISTANT SECRETARY 0 306815 0 80613 0 1372 0 116962 0 43862 0 549624 0 80613 MELINDA MENDOZA VP/CHIEF COMPLIANCE OFFICER 0 412598 0 0 0 70 0 113919 0 16929 0 543516 0 0 JUSTIN BOLLENBACK REGION VP FINANCE (PARTIAL) 0 104662 0 103609 0 292205 0 3669 0 16446 0 520591 0 98805 TREVOR SMITH FORMER OFFICER 301055 0 73822 0 215 0 79732 0 43389 0 498213 0 73822 0 TERRI DRAPER REGION VP MARKETING (PARTIAL) 0 239767 0 44612 0 37921 0 144484 0 27308 0 494092 0 0 NADIA KHAN REGION VP MARKETING (PARTIAL) 110989 0 127091 0 228993 0 13770 0 7828 0 488671 0 79357 0 BEAU HARRISON VP STRATEGY 0 292691 0 53818 0 1472 0 90449 0 42023 0 480453 0 53818 DEV RAMSAMY REGION VP FINANCE (PARTIAL) 261156 63938 37260 0 1049 235 0 91724 4535 9411 304000 165308 0 0 PART I, LINE 1A THE REGION PRESIDENT, MITCHELL CLOWARD, WAS PROVIDED HOUSING ON A TEMPORARY BASIS AS PART OF A RELOCATION PACKAGE; THESE BENEFITS ARE REPORTED AS TAXABLE TO THE EMPLOYEE ON FROM W-2. PART I, LINE 3 THE COMPENSATION COMMITTEE OF THE INTERMOUNTAIN HEALTH CARE, INC. BOARD (A RELATED NONPROFIT ORGANIZATION) RETAINS OUTSIDE CONSULTANTS TO PROVIDE OBJECTIVE DATA ON COMPENSATION LEVELS AND PRACTICES. THE COMMITTEE ANNUALLY ANALYZES THIS DATA AND MAKES COMPENSATION DECISIONS, WHICH ARE REVIEWED BY THE FULL BOARD OF TRUSTEES. THE BOARD PLACES A HIGH PRIORITY ON THE NEED TO RECRUIT AND RETAIN A STRONG LEADERSHIP TEAM AND TO CREATE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE TO DRIVE SUPERIOR ORGANIZATIONAL PERFORMANCE TO BECOME A TOP-TIER INTEGRATED HEALTH SYSTEM. COMPENSATION LEVELS FOLLOW IRS GUIDELINES AND ARE SUBJECT TO IRS OVERSIGHT. A PORTION OF THE COMPENSATION REPORTED ON THIS FORM REFLECTS DEFERRED AMOUNTS THAT ARE NOT VESTED, ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE, AND MAY OR MAY NOT BE PAID IN THE FUTURE. THE REPORTABLE COMPENSATION ON SCHEDULE J INCLUDES CERTAIN AMOUNTS THAT HAVE BEEN OR WILL BE REPORTED TWICE, BOTH IN THE YEAR ACCRUED AND AGAIN IN THE YEAR PAID. PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT IN 2024: - JUSTIN BOLLENBACK $291,876 - SUZANNE DRAPER $1,140,791 - NADIA KHAN $228,560 - CUONG NGYUN, MD $75,625 THE FILING ORGANIZATION OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. PARTICIPATION IN THE PLAN IS LIMITED TO EMPLOYEES DESIGNATED BY THE BOARD. THE AMOUNTS IN THE PLAN ARE NOT VESTED, ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE, AND MAY OR MAY NOT BE PAID IN THE FUTURE. FORM 990, PART VI, SECTION A, LINE 2 CLAY L. ASHDOWN / GREG J. MATIS - BUSINESS RELATIONSHIP (TRUSTEES OF MOUNTAIN WEST HEALTH CAPTIVE, A RELATED TAXABLE CORPORATION) FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF INTERMOUNTAIN MEDICAL HOLDINGS NEVADA, INC. IS INTERMOUNTAIN HEALTH CARE, INC., A UTAH NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE FILING ORGANIZATION'S TRUSTEES ARE ELECTED BY THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B UNDER THE ARTICLES OF INCORPORATION, THE SOLE MEMBER EXERCISES ALL PROPERTY, VOTING, AND OTHER RIGHTS, INTERESTS, AND POWERS CONFERRED UNDER LOCAL STATUTE. FORM 990, PART VI, SECTION B, LINE 11B INTERMOUNTAIN MEDICAL HOLDINGS NEVADA, INC.'S BOARD REVIEWED AND/OR WAS PROVIDED COPIES OF THE TAX RETURN PRIOR TO FILING IT WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, AND TRUSTEE IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AT LEAST ANNUALLY. THESE INDIVIDUALS HAVE BEEN INSTRUCTED TO UPDATE THEIR QUESTIONNAIRE INFORMATION IF THEY BECOME AWARE OF A NEW POTENTIAL CONFLICT, OR IF ANY OF THE PREVIOUSLY REPORTED INFORMATION CHANGES. ADDITIONALLY, BOARD MEMBERS ARE ASKED AT THE BEGINNING OF EACH BOARD OR COMMITTEE MEETING IF THEY ARE AWARE OF ANY CONFLICTS. ACCORDING TO POLICY, THE QUESTIONNAIRES ARE COLLECTED AND REVIEWED BY IHC HEALTH SERVICES, INC.'S (A WHOLLY OWNED SUBSIDIARY OF INTERMOUNTIAN HEALTHCARE, INC.) CHIEF COMPLIANCE OFFICER. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED WITH APPROPRIATE PERSONNEL, WHICH MAY INCLUDE (BUT IS NOT LIMITED TO) THE AUDIT AND COMPLIANCE COMMITTEE CHAIR, SENIOR MANAGEMENT AND THE LEGAL DEPARTMENT OF IHC HEALTH SERVICES, INC. IF AN INDIVIDUAL DISCLOSES A SITUATION THAT POSES A CONFLICT OF INTEREST, A DETERMINATION IS MADE WHETHER THE SITUATION CAN BE MANAGED (SUCH AS BY RECUSAL IN DECISION-MAKING SETTINGS) OR MUST BE ELIMINATED (SUCH AS THROUGH DIVESTITURE OF THE OUTSIDE INTEREST OR REQUIRING A CHOICE OF THE INDIVIDUAL'S ROLE WITH THE FILING ORGANIZATION OR THE OUTSIDE ENTITY). FINDINGS ARE REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF INTERMOUNTAIN HEALTH CARE, INC. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE ("COMPENSATION COMMITTEE"), A SUBSET OF INTERMOUNTAIN HEALTH CARE, INC.'S GOVERNING BODY, IS RESPONSIBLE FOR THE PROCESS OF ANNUALLY DETERMINING THE TOTAL COMPENSATION PACKAGES (INCLUDING CASH AND NONCASH BENEFITS) FOR THE PRESIDENT. THE COMPENSATION COMMITTEE ANNUALLY RETAINS AN INDEPENDENT, EXTERNAL CONSULTING FIRM TO PROVIDE AN ANALYSIS OF COMPARABLE MARKET DATA. THE CONSULTANTS REVIEW THE VARIOUS TYPES OF DIRECT COMPENSATION, INCLUDING BASE SALARY, TOTAL CASH, AND ANNUAL AND LONG-TERM INCENTIVES. INFORMATION FROM A SELECTED GROUP OF COMPARABLE NONPROFIT ORGANIZATIONS IS USED TO SUPPLEMENT PUBLISHED SURVEY DATA. THE CONSULTANTS ALSO CONDUCT AN IN-DEPTH ANALYSIS OF THE ASSOCIATED BENEFITS AND PERQUISITES. INFORMATION PROVIDED BY THE EXTERNAL CONSULTANTS IS REVIEWED BY THE COMPENSATION COMMITTEE ALONG WITH THE PERFORMANCE DATA FOR EACH OFFICER LISTED ABOVE. DECISIONS BY THE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED. THE COMPENSATION COMMITTEE PRESENTS THE COLLECTED INFORMATION AND THE ASSOCIATED COMPENSATION DECISIONS TO THE ENTIRE BOARD OF TRUSTEES. INTERMOUNTAIN MEDICAL HOLDINGS NEVADA, INC.'S PHILOSOPHY IS TO PAY COMPENSATION AT MARKET COMPETITIVE RATES. THE DETERMINATION OF EXECUTIVE COMPENSATION IS ALSO DESIGNED TO MEET THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" STANDARD AS OUTLINED IN THE TREASURY REGULATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION DIDN'T MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE DURING THE TAX YEAR. 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